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Malperfusion on CPB — FRCA Final MCQ

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HardCardiothoracic AnaesthesiaMalperfusion on CPBFRCA Final

On CPB: lactate 8, metabolic acidosis, falling SvO2, adequate pump flow, distended aortic root. Diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Aortic dissection with malperfusion

Rising lactate + falling SvO2 + adequate flow + aortic root distension = aortic dissection or cross-clamp slip with false lumen perfusion. Catastrophic event requiring immediate recognition. Malperfusion syndrome → multiorgan failure if uncorrected.

Reference: RCOA – 2023 – Emergencies during CPB